Background

Disordered eating behaviors, (Loss of Control [LOC] and Binge Eating Disorder [BED]), are short-term predictors of suboptimal 1-year post-metabolic and bariatric surgery (MBS) weight response, but little is known about long-term outcomes. This study examined the associations of LOC/BED and 10-year %BMI change among those who had MBS as an adolescent.

Methods

Teen-LABS is a prospective observational study of adolescents ≤19 years who completed MBS at five US centers between 2007-2012. Of the 260 enrollees, longitudinal data from 228 participants (88%) who underwent Roux-en-Y gastric bypass or sleeve gastrectomy were examined from baseline to 10 years by stratifying participants into those who: (1) never reported LOC (47%) or BED (78%), (2) reported baseline LOC/BED only (15%/12% respectively), or (3) LOC/BED fluctuated over time (38%/10% respectively). Associations between these groups and %BMI change were evaluated using linear mixed modeling.

Results

Adjusted models found that %BMI change varied over time for LOC and BED, (LOC/BEDgroup*time interaction p<0.05). For both LOC and BED, %BMI loss was similar through the 2nd post-operative year; but through years 3-10, %BMI loss was significantly lower for those with fluctuating disordered eating behaviors. %BMI loss at 10 years was -23% for those never reporting LOC, -27% among those with LOC at baseline only, and -15% with fluctuating LOC status over time. Comparable results for BED were -22%, -24%, and -6%, respectively.

Conclusions

These findings highlight the need for attention to disordered eating behaviors in the long-term care of adolescent MBS patients to maximize durable weight loss.